不同分期梅尼埃病患者眼肌前庭诱发肌源性电位及冷热试验检测分析

Application of Ocular Vestibular Evoked Myogenic Potential and Caloric Test to Different Stages of Meniere Disease

目的探讨不同听力分期梅尼埃病(Meniere disease,MD)患者眼肌前庭诱发肌源性电位(ocular vestibular evoked myogenic potential,oVEMP)及冷热试验(caloric test)的特征及临床意义。方法对确诊的MD患者55例(52.8±15.8岁),按MD听力分期标准分为1期9例(48.8±13.8岁),2期9例(46.0±16.3岁),3期23例(50.3±13.5岁),4期14例(53.5±16.2岁),分别行oVEMP检测及冷热试验,分析其结果。结果 1、2、3、4期MD患者oVEMP异常率分别为55.6%(5/9)、66.7%(6/9)、78.3%(18/23)、78.6%(11/14),冷热试验异常率分别为22.2%(2/9)、33.3%(3/9)、78.3%(18/23)、85.7%(12/14);可引出oVEMP的1、2、3、4期MD患者其振幅分别为4.3±4.0、3.5±2.3、2.5±2.4、1.3±0.5μV。结论 MD患者oVEMP及冷热试验异常率随其听力受损程度加重呈上升趋势,oVEMP振幅呈下降趋势,提示椭圆囊与水平半规管的损伤加重。

Objective To investigate the characteristics and clinical significance of ocular vestibular evoked myogenic potential（oVEMP）and caloric test in Meniere disease（MD）at different hearing stages.Methods Fiftyfive patients（52.8±15.8years old）with MD were divided into stage 1（9cases,48.8±13.8years old）,stage 2（9cases,46.0±16.3years old）,stage 3（23cases,50.3±13.5years old）and stage 4（cases 14,53.5±16.2years）respectively according to the pure tone audiometry.They were evaluated by oVEMP and caloric test.Results The abnormal rates of oVEMP were 55.6%,66.7%,78.3%,78.6%,and caloric tests were 22.2%,33.3%,78.3%,and 85.7% respectively in stage 1,2,3,and 4MD patients.The amplitudes of oVEMP in stage of 1,2,3,and 4MD patients were 4.3±4.0μV,3.5±2.3μV,2.5±2.4μV,and 1.3±0.5μV,respectively.Conclusion The abnormal rates of oVEMP and caloric tests in MD patients increased with the degree of hearing impairment and the amplitudes of oVEMP were decreased,suggesting that utricle and horizontal semicircular canal injuries were aggravated.